Am J Clin Dermatol. 2014 Aug;15(4):339-56. doi: 10.1007/s40257-014-0085-5.
Skin cancer is the most common malignancy in humans with basal cell carcinoma representing the majority of cases in the general population. The prevalence of skin cancer is increased amongst immunosuppressed patients such as those with lymphoproliferative disorders including non-Hodgkin lymphoma and chronic lymphocytic leukemia or those with iatrogenic immunosuppression following organ transplantation. In addition, these patients experience greater morbidity and mortality associated with skin cancers. The most common skin cancer in immunosuppressed patients is squamous cell carcinoma, which often presents with more aggressive features and has a greater rate of metastasis. This article reviews the risk factors, etiology, clinical presentation, and prevalence of skin cancer amongst immunosuppressed patients, including organ transplant, lymphoproliferative disorders, autoimmune disorders, and human immunodeficiency virus. We also provide a comprehensive review of treatment guidelines for immunosuppressed patients with cutaneous malignancy. Surgical therapy is the cornerstone of treatment; however, we also discuss pharmacologic treatment options, lifestyle modifications, and revision of immunosuppressive regimens.
皮肤癌是人类最常见的恶性肿瘤，基底细胞癌在普通人群中占大多数。皮肤癌在免疫抑制患者中的发病率增加，如患有淋巴增生性疾病（包括非霍奇金淋巴瘤和慢性淋巴细胞白血病）或因器官移植后医源性免疫抑制的患者。此外，这些患者与皮肤癌相关的发病率和死亡率更高。免疫抑制患者中最常见的皮肤癌是鳞状细胞癌，其常具有更具侵袭性的特征，且转移率更高。本文综述了免疫抑制患者（包括器官移植、淋巴增生性疾病、自身免疫性疾病和人类免疫缺陷病毒）的皮肤癌的危险因素、病因、临床表现和流行情况。我们还提供了针对患有皮肤恶性肿瘤的免疫抑制患者的治疗指南的全面综述。手术治疗是治疗的基石；但是，我们还讨论了药物治疗选择、生活方式改变和免疫抑制方案的修订。
